Weight-normative messaging predominates on TikTok—A qualitative content analysis

Tiktok is a social media platform with many adolescent and young adult users. Food, nutrition, and weight-related posts are popular on TikTok, yet there is little understanding of the content of these posts, and whether nutrition-related content is presented by experts. The objective was to identify key themes in food, nutrition, and weight-related posts on TikTok. 1000 TikTok videos from 10 popular nutrition, food, and weight-related hashtags each with over 1 billion views were downloaded and analyzed using template analysis. The one-hundred most viewed videos were downloaded from each of the ten chosen hashtags. Two coders then coded each video for key themes. Key themes included the glorification of weight loss in many posts, the positioning of food to achieve health and thinness, and the lack of expert voices providing nutrition information. The majority of posts presented a weight-normative view of health, with less than 3% coded as weight-inclusive. Most posts were created by white, female adolescents and young adults. Nutrition-related content on TikTok is largely weight normative, and may contribute to disordered eating behaviors and body dissatisfaction in the young people that are TikTok’s predominant users. Helping users discern credible nutrition information, and eliminate triggering content from their social media feeds may be strategies to address the weight-normative social media content that is so prevalent.

scientifically appropriate nor robust as a method We respectfully disagree that the discussion reads meaning into the text of the videos. The discussion section identifies themes that emerged from the videos and then uses examples from the videos to illustrate those themes. The discussion also explains why these themes may be helpful or hurtful to a viewer. The authors are not implying that a particular creator meant to for example, glorify weight loss, but any video that spoke positively of weight loss was coded into this theme, and then previous research has indicated how the glorification of weight loss may be harmful. In the discussion we hoped to help readers realize why the themes we identified were important, we meant to provide meaning to our themes, not to interpret particular videos beyond categorizing them into our themes. We have made sure to tone down any causative language that may have been in the discussion which hopefully will help with this concern. If you can provide specific examples of where you feel we have over-reached in our discussion, we are happy to revise. 4. Limitation -please mention that this reflects only one social media platform and the study would have been richer if other platforms such as Instagram would have been included We have added this as a limitation.

5.
Please specify clearly what time period the data was collected-some places 'fall' is mentioned and another place September...this analysis is very sensitive to time and what was trending then may not be trending now..please mention in limitations The posts were collected in September 2020, we have specified this throughout the manuscript. We have added a limitation about how trends continue to change on TikTok, although the hashtags we analyzed have substantially more views today than they did when we analyzed them, indicating that they continue to be popular on TikTok.
6. The discussion currently presents new data with interpretation..please consider deepening the analysis on what the study tells us, who it would benefit what kinds of action can be recommended ..how this study contributes or relates to other scientific literature. We have restructured the paper to have a combined results/discussion section presented by theme. We feel that this structure better presents our quantitative and qualitative data. In the discussion section we have also added several tie ins to previous literature on social media. We have recommended that adults help young adults curate their social media feeds and improve their evidence analysis skills. We also think it's important for experts to begin to engage on social media platforms to highlight weight-inclusive content. We have highlighted these suggestions in our discussion. As this paper didn't study possible solutions to the weight-normative inaccurate content on TikTok, we can only offer suggestions for future research.

Editor's Comments
We believe we have addressed all of the editor's comments. Thank you.

92
Hashtags are used on social media to collect content related to a specific topic. On 93 TikTok, users can add hashtags to the caption of their post with the hash sign (#) prefacing a 94 word or phrase. When users then click or search certain hashtags or topics, they will be brought 95 to a feed of videos with that hashtag. In this study, initially, a list of thirty body-image and 96 eating-related hashtags was collected by searching TikTok for food, nutrition, weight and body 97 image related content, and noting which hashtags were commonly used by creators and had the 98 most views. The thirty hashtags were generated both by brainstorming a possible list of food, 99 weight, and body image-related words based on professional expertise in the nutrition field, as 100 6 well as using TikTok for multiple weeks noting what hashtags were commonly used on food, 101 nutrition, and weight-related posts (see Table 1). 102 All thirty hashtags had at least 9 million views per hashtag, and the most popular had 9.7 104 billion views. From this list of thirty, we eliminated the "health" and "healthy" hashtags because 105 we felt they were too broad for the specific focus of the study, as they could include content on 106 not smoking, wearing sunscreen, getting sleep, or other health behaviors beyond the focus of this 107 study. The top ten most viewed hashtags from the original list were then included in this study 108 except for choosing #nutrition with 1.1 billion views versus #healthyfood with 1.2 billion views, 109 as it seemed important to analyze the content of videos purporting to be about nutrition which 7 could be weight inclusive or perpetuate diet culture (Table 2). Since the posts were collected in 111 September 2020, #nutrition now has more views that #healthyfood. 112 Each of the ten hashtags had more than 1.1 billion views per hashtag and we believed 114 were divided between hashtags that were likely to present weight-normative content 115 (#weightloss, #diet, #weightlossjourney, #fatloss, #weightlosscheck) or potentially contain 116 weight-inclusive or weight-neutral content (#whatieatinaday, #plussize, #mealprep, 117 #bodypositvity, #nutrition). Although the original list of thirty hashtags contained several such 118 as #intuitiveeating and #haes that may have been most likely to contain weight-inclusive content, 119 those hashtags had considerably fewer views, 111.2 million and 15.3 million respectively than 120 any of the top 10 hashtags used in this study which each had at least 1 billion views (see Table  121 1). These more specific weight-inclusive hashtags were then not selected for analysis because 122 they did not represent a large share of the food/weight/body posts viewed on TikTok, and would 123 not give an accurate idea of what the "average" TikTok viewer would find on their for you page, 124 as the for you page is most likely to display videos with many views. The first 100 videos under 125 8 each of the ten selected hashtags as well as a screenshot of their first frame and caption were 126 downloaded in September 2020, and the files were each labeled with the hashtag and record 127 number. The videos were publicly available and downloadable, so our collection and analysis 128 complied with necessary terms and conditions. TikToks in each hashtag are displayed from the 129 most views to the least views, so downloading the first 100 videos in each hashtag meant that the 130 most viewed videos in each hashtag were collected. Any TikToks that were not downloadable 131 were not included in the study, as a small percentage of users do not allow their videos to be 132 downloaded. Because all videos were publicly available, the study was approved as exempt by 133 the University of Vermont Committee on Human Research in the Behavioral and Social 134 Sciences, STUDY00001190. As all of the TikTok videos analyzed were publicly available, 135 informed consent was waived by the ethics committee. 136

137
After preliminary analysis of a subset of 100 TikToks (10 from each hashtag), a list of 138 codes was developed using a template analysis approach that included codes that we expected to 139 find in the data such as posts that were food related, depicted exercise, reflected someone's 140 body image, represented weight normativity or weight inclusivity, or discussed weight loss, as 141 well as codes reflecting themes that emerged from the subset of TikToks [24]. Demographic 142 codes for age, gender presentation, race/ethnicity, and body size were also included in the 143 codebook, as was a code noting any professional degrees of the user. After codebook creation, 144 two coders watched and coded ten videos from each of the hashtags. Codes from each coder 145 were compared to ensure consistency of code application. Coders then proceeded to code the 146 remainder of the TikTok videos independently. Once all coding was completed individually, 147 cross comparisons were run in Excel between the two coders' spreadsheets to identify any 148 9 differences in coding. Videos with discrepancies were viewed again by two coders together and 149 final codes were agreed upon. In total, four coders worked on the project with two coders coding 150 each video. The study authors trained the two additional coders who were nutrition 151 undergraduate students. When coding discrepancies were noted, the two study authors looked at 152 each video and determined final coding. All codes used in the codebook except for demographic 153 codes can be found in the linked supplementary material file.  TikTok content was analyzed using thematic analysis with quantification, which allowed 164 us to identify, analyze, and report key themes from the qualitative TikTok data [25]. Code 165 frequencies were tabulated using SPSS Software (IBM Corp., Chicago). The frequency data 166 helped identify how often various codes and resulting themes appeared in each hashtag. The 167 research group reviewed and refined key themes together, and identified TikToks that were 168 emblematic of each key theme. The analytic plan was pre-specified, and the hypotheses were 169 determined before data was collected. in a day to lose weight. In fact, the whatieatinaday hashtag has become so weight normative and 202 triggering that videos using it now carry a trigger warning for eating disorders including a link to 203 the National Eating Disorder Association's help line because so many people were using the 204 hashtag to show how little they ate in a day [21]. 205 The glorification of weight loss across many videos, and reoccurring suggestion that if you 206 just try hard enough you can lose weight too, undoubtedly elevate the key principles of weight 207 normativity, and may reinforce to viewers the belief that weight is an important indicator of 208 health status and overall self-worth [9, 30]. This danger is increased by the substantial number of 209 views that these hashtags are receiving. The weight loss hashtag alone had almost 10 billion 210 views at the time the videos were collected, showing that billions of people are interested enough 211 in losing weight to engage with the hashtag. The number of views the weight-loss focused 212 hashtags received vastly outnumbered the number of views more explicitly weight-inclusive 213 hashtags received (see Table 1). In our study, less than 3% of all videos were coded for weight 12 inclusive messaging or content, suggesting that weight-inclusive messaging is not prevalent 215 across some of the most viewed nutrition, food, and body-related hashtags on TikTok. 216 Among the videos that depicted weight loss transformation, common themes included 217 exercise routines and diet plans, often with images of routine weigh-ins and clothing "down-218 sizes." Twenty-two percent of videos depicted physical activity. Many of the videos depicting 219 physical activity were also coded for weight loss, indicating that physical activity was being 220 portrayed not for its inherent benefits to physical and mental health [31], but as a means to 221 achieve weight loss. In multiple cases, the creator mentioned finally becoming "happy" after 222 losing the weight, and how their journey to "better themselves" was not done yet, exemplifying 223 diet culture's message that a person's body size is indicative of their health and moral status. 224 As discussed earlier, TikTok is unique in that users can choose from a variety of sounds 225 to add to their videos. Several sounds were found to occur frequently as part of the weight loss 226 trends and included language that poses weight loss as paramount. Dialogue, sounding like a pep 227 talk from a coach or a trainer, containing phrases such as "no excuses," "get up" and "if you 228 want it bad enough, you'll do it," implies that not trying to lose weight makes you lazy, and 229 inferior to those who are pursuing weight loss. These videos may give viewers the idea that 230 intense weight loss transformations are both attainable and something to strive fornot only for 231 appearance purposes but also for physical and mental well-being as previous research has 232 illustrated the strong influence that media reinforcing the thin ideal has on people's self image 233 body image because they had lost weight, and rarely were depicting body positivity for a body 251 that would not be deemed "acceptable" by diet culture. Similarly, while there were videos that 252 mentioned or showed a person's weight gain, these videos were the minority of weight-related 253 content and reinforced diet culture beliefs. Weight-gain content tended to be masked with body 254 positive hashtags and mentions of "self-love," but still suggested that weight gain is inherently 255 negative. Voice-overs and comments in these videos excused their weight gain or reassured 256 themselves that it was okay to have gained weight. For example, a common caption would be 257 something like, "I gained 20 pounds, but I still love myself." Having to state that you still love 258 yourself when your weight increases suggests exposure to weight bias and fat phobia [40]. Such 259 14 weight-related stigmas lead to social issues such as devaluation, discrimination and rejection of 260 individuals who are in fat bodies [40]. 261

262
Thirty-eight percent of videos explicitly showed food (cooking, eating, getting take-out 263 etc.), and 11.9% of videos featured active cooking. A major theme that emerged about the food 264 content in the chosen hashtags was that food content seemed to be devoid of pleasure or 265 social/cultural influences, and instead was perceived as a means of pursuing health or wellness. liquid "cleanses," and intermittent fasting. These tended to be posed as ways to achieve a certain 269 body "goal." A noticeable number of users also shared videos of themselves making weight loss 270 or detox teas or drinks, to which they attributed their weight loss. Videos like this may be 271 especially deceptive for a viewer because often the diet or recipe is paired with a thin, attractive 272 person, leaving the impression that the drink played a role in attaining the idealized body type. 273 Another theme among food content was instructional videos of users showing how to make 274 "healthy" versions of "junk" foods. Assigning good or bad labels to food brings emotion and 275 morality to eating. These emotions are internalized as we eat, and eating a food deemed "bad" by 276 diet culture's standards may lead to negative perceptions of self after consumption [41]. 277 Moralizing food can cause hyper-awareness about food choices, and foster beliefs that certain 278 foods should be avoided because they will cause weight gain or poor health. This can lead to 279 development of eating disorders such as Orthorexia Nervosa, an eating disorder defined as the 280 obsession with "correct" eating and a fixation on foods' role in our physical health [41,42]. 281

282
Of all videos coded under the hashtag "nutrition," 47% provided some sort of nutrition 283 advice. These videos primarily offered advice about what foods to eat for different purposes, 284 mostly for weight loss, as one quarter of videos also referenced weight loss in addition to 285 providing nutrition advice. An example pattern would be users showing their weight 286 transformation, paired with explaining "what they ate on their journey." This suggests again that 287 the purpose of food is to manipulate body size rather than for social or cultural fulfillment. 288 Another key finding was the lack of professional representation on TikTok. Given the high 289 percentage of videos that provided nutrition advice to viewers, it is surprising how few came 290 from a health professional. Of all the videos, 1.4% were created by registered dietitians, 291 suggesting very little expert nutrition advice on the app. Users without professional knowledge 292 are sharing nutrition tips that can be inaccurate, and often for the purposes of weight loss. These As seen in the current study, content displaying diet culture themes is often present on 300 social media, a primary source of information for many young adults. In regard to health 301 behaviors such as eating, exercise, or body image, young people are vulnerable to the influence 302 of social media content, and are not always able to discern which posts offer evidence-based 303 advice and which do not [26,27]. Exemplifying the impact of media on body image, 304 Tiggemann and Miller found that adolescent girls who reported more time spent on social media 305 were also more likely to have high internalization of the thin ideal [28]. This is not surprising 306 when content on social media commonly represents ideas that are rooted in diet culture and 307 weight normativity as seen in the current study. Acknowledging the weight-normative content 308 on social media is important if health practitioners would like to help young people develop 309 healthy relationships with food and their bodies. for their users [20]. While it is significant that the platform has acknowledged the danger of diet 316 culture content trending on their app, the content used in this study was collected after the initial 317 changes were made, indicating that the problem is still pressing; even with PSA's and resources, 318 diet culture remains a viral topic. For example, recent trends targeted quarantine bodies, 319 promoting fad diets, exercise routines, and diet supplements advertised to help lose the weight 320 gained during lockdown as we approach a post-pandemic lifestyle [43,44]. 321 Perhaps diet culture can be combatted by the spread of weight-inclusive content, such as 322 Health at Every Size and Intuitive Eating focused content, which work to celebrate the diversity 323 of body sizes, and reject weight as a symbol of health and morality. A wide range of literature 324 has found these weight inclusive models to have many benefits, such as improvement of eating 325 disorder behaviors, as well as associations with improved physical and mental health outcomes 326 The dearth of expert voices on TikTok is difficult to combat, because it is challenging for 331 experts like Registered Dietitians to garner views by mastering the TikTok algorithm, which 332 often demands that one's content is appealing to adolescents and young adults. Social media 333 success can be cultivated by experts but takes concerted creative effort, time investment, and the 334 right persona. Especially on TikTok, videos go viral in a way that is largely controlled by the 335 proprietary algorithm that places videos on users' for you pages. Therefore, although certainly it 336 would help if more registered dietitians were able to gain attention on TikTok, it may be more 337 realistic to help adolescents and young adults learn how to discern expert advice from 338 unqualified advice by working on their media evidence analysis skills. Building media literacy 339 for young adults is important, as previous research has found that media literacy may help 340 decrease body dissatisfaction and thin-ideal internalization [48]. It may also behoove 341 practitioners to discuss what type of content young adults are seeing on TikTok and how they 342 could begin to avoid the weight-normative content on the app if they would like to by blocking 343 or unfollowing particular accounts. Helping young adults curate their social media feeds is one 344 way to reduce exposure to diet culture messaging. Future research should focus on how health 345 experts can best engage with youth on platforms like TikTok. 346   Tiktok is a social media platform with many adolescent and young adult users. Food, nutrition, 14 and weight-related posts are popular on TikTok, yet there is little understanding of the content of 15 these posts, and whether nutrition-related content is presented by experts. The objective was to 16

Strengths and Limitations
identify key themes in food, nutrition, and weight-related posts on TikTok. 1000 TikTok videos 17 from 10 popular nutrition, food, and weight-related hashtags each with over 1 billion views were 18 downloaded and analyzed using template analysis. The one-hundred most viewed videos were 19 downloaded from each of the ten chosen hashtags. Two coders then coded each video for key 20 themes. Key themes included the glorification of weight loss in many posts, the positioning of 21 food to achieve health and thinness, and the lack of expert voices providing nutrition 22 information. The majority of posts presented a weight-normative view of health, with less than 23 3% coded as weight-inclusive. Most posts were created by white, female adolescents and young 24 adults. Nutrition-related content on TikTok is largely weight normative, and may contribute to 25 disordered eating behaviors and body dissatisfaction in the young people that are TikTok's 26 predominant users. Helping users discern credible nutrition information, and eliminate 27 triggering content from their social media feeds may be strategies to address the weight-28 normative social media content that is so prevalent. 29

30
Social media is incredibly popular with young adults [1], and may be an arena where 31 young adults are exposed to content that perpetuates diet culture. Diet culture is a system of 32 beliefs that worships thinness, promotes weight loss as a means of attaining higher status, 33 demonizes certain ways of eating while encouraging others, and oppresses people who do not Weight normativity posits that health is only possible at a specific weight, weight and 41 disease are linearly related, and one has a personal responsibility for meeting weight expectations 42 [9]. Because weight is seen as integral to health, the weight-normative approach focuses on 43 weight management and achieving a "normal" weight. The ubiquitous nature of diet culture 44 follows logically from weight normativity as weight management is seen by both as essential to 45 health. In contrast to weight normativity, the weight-inclusive view of health recognizes that 46 bodies come in a variety of shapes and sizes, and believes that people in all body sizes can 47 achieve health if given the opportunity to pursue health behaviors and access to non-stigmatizing 48 health care [9]. Importantly, weight-inclusivity does not define weight control as a health 49 behavior. As weight-inclusive approaches are associated with improved physical and mental 50 health outcomes, weight-inclusive messaging may help foster health promoting behaviors . this increasingly popular social media site is that the app consists only of short videos created by 62 its users. The app is very user friendly, providing a wide array of tools for creators to utilize such 63 as filters, special effects and sounds from popular songs, TV shows, their own voice or other 64 popular TikToks. TikTok is also notorious for trends; a certain dance, sound, prompt or hashtag 65 will go viral and other users will then create their own versions. With TikTok, users don't need 66 to follow certain accounts, or even have their own account, to view posts tailored to them. The 67 default page on the app is its "for you" page, with endless, algorithmically curated videos based 68 on content that a user has interacted with or watched previously. Therefore, the TikTok 69 algorithm literally tailors content "for you." If someone consistently engages with diet, weight 70 loss, or food content those videos will continue to appear unless the user actively selects a 71 window labeled "not interested." 72 The potential exposure to endless weight or food-related content becomes more

92
Hashtags are used on social media to collect content related to a specific topic. On 93 TikTok, users can add hashtags to the caption of their post with the hash sign (#) prefacing a 94 word or phrase. When users then click or search certain hashtags or topics, they will be brought 95 to a feed of videos with that hashtag. In this study, initially, a list of thirty body-image and 96 eating-related hashtags was collected by searching TikTok for food, nutrition, weight and body 97 image related content, and noting which hashtags were commonly used by creators and had the 98 most views. The thirty hashtags were generated both by brainstorming a possible list of food, 99 weight, and body image-related words based on professional expertise in the nutrition field, as 6 well as using TikTok for multiple weeks noting what hashtags were commonly used on food, 101 nutrition, and weight-related posts (see Table 1). 102 All thirty hashtags had at least 915 million views per hashtag, and the most popular had 104 9.7 billion views. From this list of thirty, we eliminated the "health" and "healthy" hashtags 105 because we felt they were too broad for the specific focus of the study, as they could include 106 content on not smoking, wearing sunscreen, getting sleep, or other health behaviors beyond the 107 focus of this study.. The top ten most viewed hashtags from the original list were then chosen to 108 be included in this study except for choosing #nutrition with 1.1 billion views versus 109 #healthyfood with 1.2 billion views, as it seemed important to analyze the content of videos 110 purporting to be about nutrition which could be weight inclusive or perpetuate diet culture (Table 7 2). Since the posts were collected in Fall September 2020, #nutrition now has more views that 112 #healthyfood. 113 Each of the ten hashtags had more than 1.1 billion views per hashtag and we believed 115 were divided between hashtags that were likely to present weight-normative content 116 (#weightloss, #diet, #weightlossjourney, #fatloss, #weightlosscheck) or potentially contain 117 weight-inclusive or weight-neutral content (#whatieatinaday, #plussize, #mealprep, 118 #bodypositvity, #nutrition). Although the original list of thirty hashtags contained several such 119 as #intuitiveeating and #haes that may have been most likely to contain weight-inclusive content, 120 those hashtags had considerably fewer views, 111.2 million and 15.3 million respectively than 121 any of the top 10 hashtags used in this study which each had at least 1 billion views (see Table  122 1). These more specific weight-inclusive hashtags were then not selected for analysis because 123 they did not represent a large share of the food/weight/body posts viewed on TikTok, and would 124 not give an accurate idea of what the "average" TikTok viewer would find on their for you page, 125 as the for you page is most likely to display videos with many views. The first 100 videos under 126 Commented [LP(1]: Editor had asked for a revision here, but these numbers are actually correct, all hashtags actually used in the study had at least 1 billion views.

138
After preliminary analysis of a subset of 100 TikToks (10 from each hashtag), a list of 139 codes was developed using a template analysis approach that included codes that we expected to 140 find in the data such as posts that were food related, depicted exercise, reflected someone's 141 body image, represented weight normativity or weight inclusivity, or discussed weight loss, as 142 well as codes reflecting themes that emerged from the subset of TikToks [24]. Demographic 143 codes for age, gender presentation, race/ethnicity, and body size were also included in the 144 codebook, as was a code for noting any professional degrees of the user. After codebook 145 creation, two coders watched and coded ten videos from each of the hashtags. Codes from each 146 coder were compared to ensure consistency of code application. Coders then proceeded to code 147 the remainder of the TikTok videos independently. Once all coding was completed individually, 148 cross comparisons were run in Excel between the two coders' spreadsheets to identify any 9 differences in coding. Videos with discrepancies were viewed again by two coders together and 150 final codes were agreed upon. In total, four coders worked on the project with two coders coding 151 each video. The study authors trained the two additional coders who were nutrition 152 undergraduate students. When coding discrepancies were noted, the two study authors looked at  TikTok content was analyzed using thematic analysis with quantification, which allowed 165 us to identify, analyze, and report key themes from the qualitative TikTok data [25]. Code 166 frequencies were also tabulated using SPSS Software (IBM Corp., Chicago). The frequency data 167 helped identify how often various codes and resulting themes appeared in each hashtag. The 168 research group reviewed and refined key themes together, and identified TikToks that were 169 emblematic of each key theme. The analytic plan was pre-specified, and the hypotheses were 170 determined before data was collected. 171 weight normative with users showing how they meal prepped for a certain diet, or what they ate 217 in a day to lose weight. In fact, the whatieatinaday hashtag has become so weight normative and 218 triggering that videos using it now carry a trigger warning for eating disorders including a link to 219 the National Eating Disorder Association's help line because so many people were using the 220 hashtag to show how little they ate in a day [21].  Table 1). In our study, less than 3% of all videos were coded for weight 230 inclusive messaging or content, suggesting that weight-inclusive messaging is not prevalent 231 across some of the most viewed nutrition, food, and body-related hashtags on TikTok. 232 Among the videos that depicted weight loss transformation, common themes included 233 exercise routines and diet plans, often with images of routine weigh-ins and clothing "down-234 sizes." Twenty-two percent of videos depicted physical activity. Many of the videos depicting 235 physical activity were also coded for weight loss, indicating that physical activity was being 236 portrayed not for its inherent benefits to physical and mental health [31], but as a means to 237 achieve weight loss. In multiple cases, the creator mentioned finally becoming "happy" after 238 13 losing the weight, and how their journey to "better themselves" was not done yet, exemplifying 239 diet culture's message that a person's body size is indicative of their health and moral status. 240 As discussed earlier, TikTok is unique in that users can choose from a variety of sounds 241 to add to their videos. Several sounds were found to occur frequently as part of the weight loss 242 trends and included language that poses weight loss as paramount. Dialogue, sounding like a pep 243 talk from a coach or a trainer, containing phrases such as "no excuses," "get up" and "if you 244 want it bad enough, you'll do it," implies that not trying to lose weight makes you lazy, and 245 inferior to those who are pursuing weight loss. These videos may give viewers the idea that 246 intense weight loss transformations are both attainable and something to strive fornot only for 247 appearance purposes but also for physical and mental well-being as previous research has 248 illustrated the strong influence that media reinforcing the thin ideal has on people's self image 249 When looking at the data, a striking theme was the prevalence of weight-related content 302 across all ten hashtags. Many of these videos followed the same format and included similar 303 hashtags, filters, and sounds, speaking to the nature of TikTok and the ability for trends to 304 become popular. Even, the whatieatinaday hashtag and mealprep hashtags that we believed at 305 the beginning of the study may be weight-neutral and portray a variety of eating styles and meal 306 16 preparations were quite weight normative with users showing how they meal prepped for a 307 certain diet, or what they ate in a day to lose weight. In fact, the whatieatinaday hashtag has 308 become so weight normative and triggering that videos using it now carry a trigger warning for 309 eating disorders including a link to the National Eating Disorder Association's help line because 310 so many people were using the hashtag to show how little they ate in a day [21]. 311 The glorification of weight loss across many videos, and reoccurring suggestion that if you 312 just try hard enough you can lose weight too, undoubtedly elevate the key principles of weight 313 normativity, and reinforce to viewers that weight is an important indicator of health status and 314 overall self-worth [9,30]. This danger is increased by the substantial number of views that these 315 hashtags are receiving. The weight loss hashtag alone had almost 10 billion views at the time the 316 videos were collected, showing that billions of people are interested enough in losing weight to 317 engage with the hashtag. The number of views the weight-loss focused hashtags received vastly 318 outnumbered the number of views more explicitly weight-inclusive hashtags received (see Table  319 1). In our study, very few videos across all hashtags were coded as depicting weight-inclusive 320 content suggesting that weight inclusive messaging is not prevalent across some of the most 321 viewed nutrition, food, and body-related hashtags on TikTok. 322 Among the videos that depicted weight loss transformation, common themes included 323 exercise routines and diet plans, often with images of routine weigh-ins and clothing "down-324 sizes." Many of the videos depicting physical activity were also coded for weight loss, 325 indicating that physical activity was being portrayed not for its inherent benefits to physical and 326 mental health [31], but as a means to achieve weight loss. In multiple cases, the creator 327 mentioned finally becoming "happy" after losing the weight, and how their journey to "better 328 themselves" was not done yet, exemplifying diet culture's message that a person's body size is 329 Reviewer #1: This is an interesting study presented well however there are some concerns with regard to the contribution to scientific literature and rigor of methods.

The analysis done is a content analysis with quantification -please clarify this in the methods
We have clarified that the analysis was a thematic analysis with quantification.
2. There are some findings presented in the discussion such as -line 27 on page 5 An example pattern would be users showing their weight transformation, paired with explaining "what they ate on their journey." and line 245 on page 13 Dialogue, sounding like a pep talk from a coach or a trainer, containing phrases such as "no excuses," "get up" and "if you want it bad enough, you'll do it," implies that not trying to lose weight makes you lazy, and inferior to those who are pursuing weight loss. These findings have not been presented in the results..the analysis could include a thematic analysis -all transcripts (text) could be coded and then themes identified. We did conduct a thematic analysis, where we coded all videos including their dialogue, sounds, and actions to identify predominate themes. We have restructured our paper with a combined results/discussion divided by theme to more clearly delineate the themes we identified in the data.

Much of the discussion reads meaning into the text of the videos this is not scientifically appropriate nor robust as a method
We respectfully disagree that the discussion reads meaning into the text of the videos. The discussion section identifies themes that emerged from the videos and then uses examples from the videos to illustrate those themes. The discussion also explains why these themes may be helpful or hurtful to a viewer. The authors are not implying that a particular creator meant to for example, glorify weight loss, but any video that spoke positively of weight loss was coded into this theme, and then previous research has indicated how the glorification of weight loss may be harmful. In the discussion we hoped to help readers realize why the themes we identified were important, we meant to provide meaning to our themes, not to interpret particular videos beyond categorizing them into our themes. We have made sure to tone down any causative language that may have been in the discussion which hopefully will help with this concern. If you can provide specific examples of where you feel we have over-reached in our discussion, we are happy to revise.

Limitation -please mention that this reflects only one social media platform and the study would have been richer if other platforms such as Instagram would have been included
We have added this as a limitation.

5.
Please specify clearly what time period the data was collected-some places 'fall' is mentioned and another place September...this analysis is very sensitive to time and what was trending then may not be trending now..please mention in limitations The posts were collected in September 2020, we have specified this throughout the manuscript. We have added a limitation about how trends continue to change on TikTok, although the hashtags we analyzed have substantially more views today than they did when we analyzed them, indicating that they continue to be popular on TikTok.
6. The discussion currently presents new data with interpretation..please consider deepening the analysis on what the study tells us, who it would benefit what kinds of action can be recommended ..how this study contributes or relates to other scientific literature. We have restructured the paper to have a combined results/discussion section presented by theme. We feel that this structure better presents our quantitative and qualitative data. In the discussion section we have also added several tie ins to previous literature on social media. We have recommended that adults help young adults curate their social media feeds and improve their evidence analysis skills. We also think it's important for experts to begin to engage on social media platforms to highlight weight-inclusive content. We have highlighted these suggestions in our discussion. As this paper didn't study possible solutions to the weight-normative inaccurate content on TikTok, we can only offer suggestions for future research.

Editor's Comments
We believe we have addressed all of the editor's comments. Thank you.